Journal of Nutrition and Health

  • 제56권2호
  • /
  • Pages.168-183
  • /
  • 2023
  • /
  • 2288-3886(pISSN)
  • /
  • 2288-3959(eISSN)
한국영양학회 (The Korean Nutrition Society)
권호 표지
DOI QR코드

DOI QR Code

한국 20-30대 성인의 Atherogenic Index of Plasma에 따른 건강지표 및 생활습관비교

Comparison of health indicators and lifestyle according to atherogenic index of plasma in Korean adults in their 20s and 30s

  • 황보라 (동덕여자대학교 보건과학대학원 임상영양학과) ;
  • 양윤정 (동덕여자대학교 자연과학대학 식품영양학과)
  • Bora Hwang (Department of Clinical Nutrition, School of Public Health, Dongduk Women's University) ;
  • Yoon Jung Yang (Department of Food and Nutrition, College of Natural Sciences, Dongduk Women's University)
  • 투고 : 2023.01.26
  • 심사 : 2023.03.02
  • 발행 : 2023.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 20-30대 성인을 대상으로 심혈관계 질환 예측인자인 AIP가 어떤 요인들과 상관성이 있는지를 밝혀 중년 이후 심혈관계질환의 발병을 조기에 예방할 수 있도록 하는 근거를 제공하고자 수행이 되었다. 연구대상자는 2013-2015년 국민건강영양조사에 참여한 20-39세 성인 3,040명으로 AIP에 따라 5분위수로 나누어서 일반사항, 건강지표, 식습관, 영양섭취상태를 비교하였다. 남성과 여성 대상자 모두 나이가 많을수록, 비만할수록, 흡연할수록 AIP 평균이 높았고, 교육수준의 경우 남성은 교육수준이 높을수록 여성은 교육 수준이 낮을수록 AIP 평균이 높았다. 남성은 음주 정도에 따라 AIP 평균에 차이가 있었고, 운동을 하지 않는 남성이 운동을 하는 남성보다 AIP 평균이 높았다. 건강지표는 남녀 모두 AIP가 높은 분위로 갈수록 수축기 혈압, 이완기 혈압, 공복혈당, 인슐린, 총 콜레스테롤, 중성지방, LDL 콜레스테롤이 유의하게 증가하는 경향이 나타났다. 남성의 경우 당화혈색소 수치도 AIP가 높아질수록 유의하게 증가하는 경향이 나타났지만, 여성에서는 유의적인 차이는 없었고, HDL 콜레스테롤의 경우 남녀 모두 AIP가 높아질수록 수치가 유의하게 낮아지는 경향이 있었다. 식습관은 여성에서 AIP가 높은 분위수로 갈수록 아침식사를 먹지 않는 비율이 높았고, 음료의 섭취량이 높았으며 커피의 섭취량은 낮았다. AIP에 따른 영양소 섭취량은 남녀 모두 차이가 없었다. 본 연구 결과를 통해 20-30대 성인에서도 나이가 많을수록 비만할수록 흡연을 할수록 운동을 안 할수록 동맥경화의 위험도가 높아짐을 확인하였고, AIP는 젊은 성인에서도 수축기 혈압, 이완기 혈압, 공복혈당, 인슐린, 총 콜레스테롤, 중성지방, LDL 콜레스테롤, HDL 콜레스테롤 등의 건강지표와 상관성이 있었다. 또한 여성에서 음료의 섭취가 많고 커피의 섭취가 적을수록 AIP가 증가하여서 탄산음료와 가당 음료의 섭취를 줄이는 것이 바람직함을 확인하였다. 따라서 20-30대 젊은 성인도 체중조절과 바람직한 생활습관을 통해 심혈관질환 예방을 위한 노력이 필요함을 확인하였다.

Purpose: Cardiovascular disease is one of the major causes of death not only in Korea but also worldwide. Atherogenic index of plasma (AIP) has been extensively investigated, but studies on nutritional intake and eating habits are scarce. The purpose of this study was to analyze the general characteristics, dietary habits, and nutritional status of Korean adults based on their AIP values using data from the 2013-2015 Korea National Health and Nutrition Examination Survey. Methods: A total number of 3,040 adults in their 20s and 30s were included as study subjects. They were divided into quintiles according to their AIP values. Comparisons were then made among the general information, eating habits, and nutritional intake statuses of the groups. Results: The averages of AIP were different by age, obese status, education, occupation, alcohol drinking frequency, smoking, and exercise in men. As for women, the averages of AIP were different by age, obese status, education, occupation, alcohol drinking frequency, and smoking status. Except for high-density lipoprotein (HDL)-cholesterol, higher AIP values in men were associated with significant increasing trends in health indicators, including systolic and diastolic blood pressure, fasting blood glucose, insulin, hemoglobin A1c, total cholesterol, triglyceride, and low-density lipoprotein (LDL)-cholesterol. As for women, as AIP increased, systolic and diastolic blood pressure, fasting blood glucose, insulin, total cholesterol, triglyceride, and LDL-cholesterol showed significant increasing trends except HDL-cholesterol. HDL-cholesterol showed a significant decreasing trend as AIP increased in men and women. In the high AIP group of women, the frequency of breakfast was lower, whereas the frequency of alcohol beverage consumption was higher. Conclusion: Among young adults, the risk of arteriosclerosis was higher in obese, smoking, and non-exercise individuals. More frequent alcohol drink consumption in women is associated with a higher risk of arteriosclerosis. Therefore, weight and lifestyle management are necessary for the prevention of atherosclerosis among young adults.

키워드

과제정보

This study was supported by the Dongduk Women's University Grant.

참고문헌

  1. World Health Organization. Cardiovascular diseases (CVDs) [Internet]. Geneva: World Health Organization; 2021 [cited 2022 Jun 11]. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
  2. Statistics Korea. 2020 Cause of Death Statistics. Daejeon: Statistics Korea; 2020.
  3. D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008; 117(6): 743-753. https://doi.org/10.1161/CIRCULATIONAHA.107.699579
  4. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364(9438): 937-952. https://doi.org/10.1016/S0140-6736(04)17018-9
  5. Wijeysundera HC, Machado M, Farahati F, Wang X, Witteman W, van der Velde G, et al. Association of temporal trends in risk factors and treatment uptake with coronary heart disease mortality, 1994-2005. JAMA 2010; 303(18): 1841-1847. https://doi.org/10.1001/jama.2010.580
  6. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37(29): 2315-2381. https://doi.org/10.1093/eurheartj/ehw106
  7. Dokic B, Donovic N, Tadic B, Nikolic D. Factors and estimation of risk for cardiovascular diseases among patients in primary health care in Central Serbia. Cent Eur J Public Health 2015; 23(3): 195-199. https://doi.org/10.21101/cejph.a4009
  8. Dobiasova M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem 2001; 34(7): 583-588.
  9. Guelker JE, Bufe A, Blockhaus C, Kroeger K, Rock T, Akin I, et al. The atherogenic index of plasma and its impact on recanalization of chronic total occlusion. Cardiol J 2020; 27(6): 756-761. https://doi.org/10.5603/CJ.a2018.0064
  10. Holmes DT, Frohlich J, Buhr KA. The concept of precision extended to the atherogenic index of plasma. Clin Biochem 2008; 41(7-8): 631-635. https://doi.org/10.1016/j.clinbiochem.2008.01.023
  11. Niroumand S, Khajedaluee M, Khadem-Rezaiyan M, Abrishami M, Juya M, Khodaee G, et al. Atherogenic index of plasma (AIP): a marker of cardiovascular disease. Med J Islam Repub Iran 2015; 29: 240.
  12. Garg R, Knox N, Prasad S, Zinzuwadia S, Rech MA. The atherogenic index of plasma is independently associated with symptomatic carotid artery stenosis. J Stroke Cerebrovasc Dis 2020; 29(12): 105351.
  13. Zhou K, Qin Z, Tian J, Cui K, Yan Y, Lyu S. The atherogenic index of plasma: a powerful and reliable predictor for coronary artery disease in patients with type 2 diabetes. Angiology 2021; 72(10): 934-941. https://doi.org/10.1177/00033197211012129
  14. Qin Z, Zhou K, Li Y, Cheng W, Wang Z, Wang J, et al. The atherogenic index of plasma plays an important role in predicting the prognosis of type 2 diabetic subjects undergoing percutaneous coronary intervention: results from an observational cohort study in China. Cardiovasc Diabetol 2020; 19(1): 23.
  15. Liu H, Liu K, Pei L, Li S, Zhao J, Zhang K, et al. Atherogenic index of plasma predicts outcomes in acute ischemic stroke. Front Neurol 2021; 12: 741754.
  16. Ahn SS, Lee LE, Pyo JY, Song JJ, Park YB, Lee SW. Atherogenic index of plasma predicts cerebrovascular accident occurrence in antineutrophil cytoplasmic antibody-associated vasculitis. Lipids Health Dis 2020; 19(1): 184.
  17. Won KB, Jang MH, Park EJ, Park HB, Heo R, Han D, et al. Atherogenic index of plasma and the risk of advanced subclinical coronary artery disease beyond traditional risk factors: an observational cohort study. Clin Cardiol 2020; 43(12): 1398-1404. https://doi.org/10.1002/clc.23450
  18. de Oliveira Caminhotto R, Fonseca FL, Castro NC, Arantes JP, Sertie RA. Atkins diet program rapidly decreases atherogenic index of plasma in trained adapted overweight men. Arch Endocrinol Metab 2015; 59(6): 568-571. https://doi.org/10.1590/2359-3997000000106
  19. Di Renzo L, Cinelli G, Dri M, Gualtieri P, Attina A, Leggeri C, et al. Mediterranean personalized diet combined with physical activity therapy for the prevention of cardiovascular diseases in Italian women. Nutrients 2020; 12(11): 3456.
  20. Ghadimi Nouran M, Kimiagar M, Abadi A, Mirzazadeh M, Harrison G. Peanut consumption and cardiovascular risk. Public Health Nutr 2010; 13(10): 1581-1586. https://doi.org/10.1017/S1368980009992837
  21. Mirmiran P, Bahadoran Z, Mirzaei S, Azizi F. Dietary intake, changes in lipid parameters and the risk of hypertriglyceridemia: a prospective approach in the Tehran lipid and glucose study. Int J Vitam Nutr Res 2014; 84(5-6): 269-276. https://doi.org/10.1024/0300-9831/a000213
  22. Cai G, Liu W, Lv S, Wang X, Guo Y, Yan Z, et al. Gender-specific associations between atherogenic index of plasma and the presence and severity of acute coronary syndrome in very young adults: a hospitalbased observational study. Lipids Health Dis 2019; 18(1): 99.
  23. Kammar-Garcia A, Lopez-Moreno P, Hernandez-Hernandez ME, Ortiz-Bueno AM, Martinez-Montano ML. Atherogenic index of plasma as a marker of cardiovascular risk factors in Mexicans aged 18 to 22 years. Proc Bayl Univ Med Cent 2021; 34(1): 22-27. https://doi.org/10.1080/08998280.2020.1799479
  24. Ahn HS, Lee LH. The relationships between obese index and major risk factors in patients with cardiovascular disease. Korean J Nutr 1993; 26(9): 1071-1084.
  25. Kim YJ, Kwak C. Prevalence and associated risk factors for cardiovascular disease: findings from the 2005, 2007 Korea National Health and Nutrition Examination Survey. Korean J Health Promot 2011; 11(3): 169-176.
  26. Shen SW, Lu Y, Li F, Yang CJ, Feng YB, Li HW, et al. Atherogenic index of plasma is an effective index for estimating abdominal obesity. Lipids Health Dis 2018; 17(1): 11.
  27. Zhu X, Yu L, Zhou H, Ma Q, Zhou X, Lei T, et al. Atherogenic index of plasma is a novel and better biomarker associated with obesity: a population-based cross-sectional study in China. Lipids Health Dis 2018; 17(1): 37.
  28. Oh MS, Jeong MH. Sex Differences in cardiovascular disease risk factors among Korean adults. Korean J Med 2020; 95(4): 266-275.
  29. Kim JJ, Yoon J, Lee YJ, Park B, Jung DH. Predictive value of the atherogenic index of plasma (AIP) for the risk of incident ischemic heart disease among non-diabetic Koreans. Nutrients 2021; 13(9): 3231.
  30. Farshchi HR, Taylor MA, Macdonald IA. Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women. Am J Clin Nutr 2005; 81(2): 388-396. https://doi.org/10.1093/ajcn.81.2.388
  31. Smith KJ, Gall SL, McNaughton SA, Blizzard L, Dwyer T, Venn AJ. Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study. Am J Clin Nutr 2010; 92(6): 1316-1325. https://doi.org/10.3945/ajcn.2010.30101
  32. Sakata K, Matumura Y, Yoshimura N, Tamaki J, Hashimoto T, Oguri S, et al. Relationship between skipping breakfast and cardiovascular disease risk factors in the national nutrition survey data. Nippon Koshu Eisei Zasshi 2001; 48(10): 837-841.
  33. Koo S, Park K. Dietary behaviors and lifestyle characteristics related to frequent eating out among Korean adults. J Korean Soc Food Sci Nutr 2013; 42(5): 705-712. https://doi.org/10.3746/jkfn.2013.42.5.705
  34. Park J, Kweon S, Kim Y, Jang M, Oh K. Dietary behaviors related to metabolic syndrome in Korean adults. Korean J Community Nutr 2012; 17(5): 664-675. https://doi.org/10.5720/kjcn.2012.17.5.664
  35. Ribas BLP, Longo A, Dobke FV, Weber B, Bertoldi EG, Borges LR, et al. Consumption of sugary drinks in patients with overt atherosclerotic disease. Cien Saude Colet 2012; 25(4): 1499-1506. https://doi.org/10.1590/1413-81232020254.12912018
  36. Malik VS, Hu FB. Fructose and cardiometabolic health: what the evidence from sugar-sweetened beverages tells us. J Am Coll Cardiol 2015; 66(14): 1615-1624. https://doi.org/10.1016/j.jacc.2015.08.025
  37. Eshak ES, Iso H, Kokubo Y, Saito I, Yamagishi K, Inoue M, et al. Soft drink intake in relation to incident ischemic heart disease, stroke, and stroke subtypes in Japanese men and women: the Japan Public Health Centre-based study cohort I. Am J Clin Nutr 2012; 96(6): 1390-1397. https://doi.org/10.3945/ajcn.112.037903
  38. Kleemola P, Jousilahti P, Pietinen P, Vartiainen E, Tuomilehto J. Coffee consumption and the risk of coronary heart disease and death. Arch Intern Med 2000; 160(22): 3393-3400. https://doi.org/10.1001/archinte.160.22.3393
  39. Choi Y, Chang Y, Ryu S, Cho J, Rampal S, Zhang Y, et al. Coffee consumption and coronary artery calcium in young and middle-aged asymptomatic adults. Heart 2015; 101(9): 686-691. https://doi.org/10.1136/heartjnl-2014-306663